June 08, 2017


Your Pregnancy, Your Way: Everything You Need to Know about Natural Pregnancy and Childbirth. By Allison Hill, M.D., with Sheila Curry Oakes. Da Capo. $16.99.

Equally Wed: The Ultimate Guide to Planning Your LGBTQ+ Wedding. By Kirsten Palladino. Seal Press. $17.99.

     The personalization and politicization of life’s milestones continue apace, and sometimes it is hard to tell when one shades into the other. Your Pregnancy, Your Way is, on the face of it, an overview of pregnancy and birth options, written by a board-certified obstetrician/gynecologist with both professional experience and personal insights from being a mother herself. That means, for example, dealing with insurance issues as they relate to the difference in licensing and practice of CNMs (certified nurse midwives) and CPMs (certified professional midwives): CNMs may have contracts with insurance companies and be covered as in-network providers, but insurance and Medicaid coverage for CPMs varies by state. However, the strictly professional and analytical material is accompanied by discussions of matters that have distinct sociopolitical overtones, as in the discussion of freebirthing: “Freebirthers believe that birth is inherently safe and relatively painless as long as the medical community doesn’t interfere. …Of 4 million births per year in the United States, approximately seven thousand are unassisted. A study in 1984 on a religious community in Indiana where women freebirthed showed an infant death rate 2.7 times higher and maternal death rate 97 times higher than the state average.” Social, political and personal beliefs repeatedly meet scientific and research-based ones here. And attitudes in other nations are part of the discussion: in the Netherlands, where 30% of babies are born at home with a midwife’s supervision, “midwife training is rigorous, competitive, and uniform.” The discussion of beliefs and attitudes is especially prominent when it comes to hot-button matters such as home-vs.-hospital birth issues (“no topic in the field of obstetrics is more polarizing”), but it is present elsewhere in Your Pregnancy, Your Way as well. The basic approach of the book is simple and straightforward: Hill discusses the different things women mean by “natural” childbirth, gives stories of women from her own experience, and includes some interesting “doctor’s diary” elements: “Inevitably, you will share your [birthing] story someday – with friends, colleagues, and your own daughter. Consider how your description will influence her perspective about childbirth in the future.” Hill covers a great deal of material in the book: eating and exercise, tests during pregnancy, risks and complications, delivery-room interventions, and much more. And the layout is somewhat scattered and not entirely focused on “natural” pregnancy (however defined). The book is, however, filled with useful information, much of it in those “doctor’s diary” entries: “A pet peeve of mine: the websites and pregnancy books that list endless foods you can’t eat while nursing…with no medical evidence whatsoever! No matter what, your baby will have days of fussiness and days of calm. …[It] is actually just the normal fluctuations of your baby’s maturing digestive system.” And while Hill returns repeatedly to the idea of keeping pregnancy and childbirth as natural as possible (again, however defined), she is commendably open about the usefulness of various interventions and substances that many readers will not consider “natural” – for instance, the prescription medicine domperidone to double milk production, the hormone oxytocin to boost milk volume, and the medication Reglan for a similar purpose. She carefully explains both the risks and the benefits of the options she discusses. And she repeatedly notes the limits of doing one’s own research: “Seventy percent of new mothers admit that they receive breastfeeding advice from the media or on the Internet, but studies show at least 25 percent of this advice is wrong.” The decision to define what a more-natural approach to pregnancy and childbirth means and then pursue it is a highly personal one, although one often driven by societal factors. Your Pregnancy, Your Way can be valuable both in helping women search for their own version of a “natural” approach and in showing the limits of that approach and the areas in which modern medicine, for all its frequent depersonalization, may be important for the health and safety of mother and baby alike.

     The personal landscape is substantially more political and more fraught with complexities for many people in what is now usually called the “LGBTQ+” community. The “+” is intended to indicate inclusion of everybody of any sexual predilection, although not all members of this group accept “straight” people – whom they call “cisgender.” In any case, there is certainly a market for books aimed at LGBTQ+ people who are interested in pursuing social matters that have long been staples of the “straight” world, such as weddings. That is where a book such as Equally Wed comes in. The “us against them” approach is strong here: “Wedding vendors and venues, as a general rule, believe in love and bring a sense of purpose to their work of bringing your vision to life and helping you make this everlasting commitment in your relationship. Only a limited number of wedding professionals are interested in working with LGBTQ+ weddings, however, so it’s important to know what they’re doing to find you.” Kirsten Palladino offers awareness of LGBTQ+ issues throughout the book, for instance by suggesting the use of terms such as “gride,” “marrier” and “nearlywed” instead of bride and groom. She also notes that “many LGBTQ+ couples propose to one another, often on different days,” and says when the second proposal occurs, “be prepared for a calmer celebration this time around, especially from the cisgender heterosexual crowd, who may not understand this LGBTQ+ tradition.” Interestingly, though, for all the assertions of uniqueness in the LGBTQ+ community where weddings are concerned, these are, after all, weddings, which are about as traditional as social ceremonies can be. Therefore, when Palladino gets beyond the assertiveness of difference between the LGBTQ+ community and everyone else, she gives advice not much different from what traditional heterosexual couples receive all the time. Tell close friends personally before you post a status update online, she says; set a realistic budget as soon as possible; send out save-the-date announcements at least six months in advance; “personalize your ceremony with culture and meaning,” as one subhead has it; and on and on. Each chapter usefully ends with “Tasks to Tackle,” which in the main are wholly traditional. “Music and Dancing,” for instance, concludes with “interview and hire musicians,” “finalize and sign contracts,” “two to four weeks before the wedding, check in with your musician to confirm every detail,” and so on. And “Making It Legal” closes with notes to “research marriage license requirements in the location where you’re getting married,” “bring your marriage license to the wedding,” “notify everyone of your new name if you’re changing it,” etc. (This chapter also has a useful and entirely traditional list of places to notify after marriage: credit-card companies, doctors’ offices, utility companies, schools, voter registration office, and so on.) Equally Wed is clearly intended to be “our” wedding guide for members of the LGBTQ+ community, but in fact its straightforward advice and commentary could have come almost entirely from any of the innumerable wedding guides that have long been published on the assumption that marriage is between a man and a woman. Using such guides, though, would apparently not be politically correct, or at least not politically satisfying, for people who identify as LGBTQ+.

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